title: Walking patterns in Parkinson's disease with and without freezing of gait.
abstract: The pathophysiology underlying freezing of gait (FOG) in Parkinson's disease remains incompletely understood. Patients with FOG ("freezers") have a higher temporal variability and asymmetry of strides compared to patients without FOG ("non-freezers"). We aimed to extend this view, by assessing spatial variability and asymmetry of steps and interlimb coordination between the upper and lower limbs during gait. Twelve freezers, 15 non-freezers, and 15 age-matched controls were instructed to walk overground and on a treadmill. Kinematic data were recorded with a motion analysis system. Both freezers and non-freezers showed an increased spatial variability of leg movements compared to controls. In addition, both patient groups had a deficit in interlimb coordination, not only between ipsilateral arms and legs, but also between diagonally positioned limbs. The only difference between freezers and non-freezers was a decreased step length during treadmill walking. We conclude that parkinsonian gait-regardless of FOG-is irregular, not only in the legs, but also with respect to interlimb coordination between the arms and legs. FOG is reflected by abnormal treadmill walking, presumably because this provides a greater challenge to the defective supraspinal control than overground walking, hampering the ability of freezers to increase their stride length when necessary.
authors.affiliation: Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Nanhoe-Mahabier
authors.forename: A H
authors.initials: AH
authors.lastname: Snijders
authors.forename: A
authors.initials: A
authors.lastname: Delval
authors.forename: V
authors.initials: V
authors.lastname: Weerdesteyn
authors.forename: J
authors.initials: J
authors.lastname: Duysens
authors.forename: S
authors.initials: S
authors.lastname: Overeem
authors.forename: B R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology*; D016138:Walking / Q000502:physiology*